0106-384 (RPL)• _% _ .
' LICENSED CONTRACTOR DECLARATION
.I hereby affirm under penalty of perjury that I am licensed under provisions of
,clChapteG 9 (commencing with Section 7000) of Division 3 of the Business and
P,Fofessionals Code, and my License is in full force and effect.
License # 5 Lic. Class Exp. Date
16 5 j2131101
r p
`'Date R " Signature of Contractor
OWNER -BUILDER DECLARATION
I hereby affirm urider penalty of perjury that I am exempt from the Contractor's
License Law for the following reason:
( )' I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals
Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I'hereby affirm under penalty of perjury one of the following declarations:
() I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
( ) I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier Policy No.
(This section need not be completed if the permit valuation is for $100.00 or less).
() I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code„ I..hall forthwith comply with Wose.provisions. ,.•�-
Date.: >o'' . Applicant °� ;,• =M ^' A°, �"....ra- Ml i r% ._� �"* :.,
Warning: Failure to secure Workers' Compensation coverage is unlawful and
shall subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages'as provided for in Section 3.706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on' his
application.
1. Each person upon whose behalf this application is made & each person at
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this applicaton.agrees to, & shall, indemnify
& hold harmless the City of La Quinta, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance'of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon'
the,above-mentioned prope yofor ppection pur os es.
Signature (Owner/Agent)_ 'W"'_ A Date �• ..
BUILDING PERMIT PERMIT #
DATE VALUATION LOT •"' TRACT
JOB SITE
APN
ADDRESS rdAEVyatAWd�iJ
-.
OWNER - ` — - -" r -
CONTRACTOR/ DESIGNER/ ENGINEER
:PURRFF,C T P0QTA ANT) C;OMROC''MYN
1.11k QUkITA CA 92253
PALM DRE=f CA 92261
(-00)568-49 3 muff Iz5
USE OF PERMIT
POOL AWDAYRL NPAt
Pt1SaU:WA. ALAii:1k75tiMA"JERSSHALLB3Nq PLACE AT PR&PLASTE1R
1NVEC; ION. POOL RQaTlPMENT iA404.0, SURF HOT IIdG4.tJ.DRD,
Nth31..ANWOR SPA 3 y60iD,4a 1�i
Pim 011541 CKPRE 101-000-4394338 l OY31.9ti
W1T..1r1*T dT01C,ti'TN FEE 1, 01-000- ti 18 -WO $162.00
MEC HANICK- L 1ITZ -- PSL 101.000.4e 1 p(*0 $24.$0
F.3.,l?.CTRJ..C.AL;P'F.Z - P001, 104-000,420•-000 045,00
PLUMIDTINC1 RE POOL 101 -M -41R-0 0 MI
- ii'AL �•�:.V�..u.CY.fCId'8.k`ALL�iD.C'J:^A7.V4w'J4WX
$363.30I.
rMqD.T FI!Xry DUE NOW
FPI
-2 2001
CITY OF LA OUINIA
ANANCE DEPT - -
RECEIPT
DATEBY
DATE FINALED
INSPECTOR
INSPECTION RECORD
M
OPERATION
DATE
INSPECTOR
I OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
'. Exhaust Fans
O.K. to. Wrap
j F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
: Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
'
i
I Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
_
Final
Undera d Pltxi. Test
was Piping
PLUMBING APPROVALS
Gas Test �qy�—,,�—
ties ;c Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Sewer Connection
Pool Cover
Encapsulation
_
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
'FROM : PURRFECT POOLS&CONSTRUCTION FAX NO. : 7603609829
Jun. 25 2001 11:44AM P3
7 sirw VY
Vl/
A -�
TM
PGA WEST
RESIDENTIAL ASSOCIATION, INC.
10)
May 22, 2001
John Puff and Dorothy Ferrante
55-300 Tanglewood
La Quinta, CA 92253 -
Dear John and Dorothy:
Mr. Don Adolph, Architectural Committee Chairman, has approved the plans to install a pool and
spa at your.55-300 Tanglewood residence. Please note: you will need to screen off pool equipment
with a stucco wall with a minimum height of 4 ft.
• Pool equipment must be screened by a stucco wall with a minimum height of 4 feet. Please
ensure that the pool equipment is not visible from common area or golf course.
• Maximum height for wall or screening on the rear property line is'30" high.
• You will need to work with golf course management regarding access via the golf course or
damage to the golf course.
We will also need to receive a copy of the total set of plans that will 'be submitted to the city for your
pool and spa. Upon completion of this work, please submit the enclosed Notice of Completion.
We appreciate your cooperation in submitting this request for approval. If I may be of further
assistance, please contact me at the HOT office, (760) 771-1234, Extension 15.
Sincerely,
fKel(lvy
Operations Manager
KM/sno
cc: Architectural Committee
enclosure (1)
P.O. Box 1060, La Quinta, California 92253, Telephone 760-771-1234 FAX 760-771-5125